Wilson Flag Football Program Registration

Wilson Flag Football Program Registration:

Athlete Name: ________________________________________________________

Parent/Guardian Name: ___________________________________________________

Address: __________________________________________________________________

City: ________________________________ State: _______ Zip: ___________________

School: _____________________ Grade: (entering in fall of ’15)________ Age: ________

Phone - Home: ___________________________ Cell: __________________________

E-mail:____________________________________________________

T-shirt/short size (youth sizes-come as set)

___ XS ___S ___M ___L ___XL

Last Name as you want it on jersey:

___________________________________

Number you want on jersey:

__________

PARENT/GUARDIAN CONSENT FORM

 I hereby give my consent for my son to participate in all activities of the Wilson Flag Football Program. I also declare my son to be in good health and give permission to the coaches to render such medical care, as in their judgment, may be advisable for my child.

 __________________________________ ____________

Signature: Parent / Guardian Date

 Please complete the form above and return to Doug Dahms with a $85 check. (Registration deadline is July 30; late registration is $100 by August 18; after August 18 registration is $85 but no uniform is included)

Please make checks payable to Wilson Football.

Forms may be returned to: Wilson Football

c/o Doug Dahms

2601 Grandview Boulevard

West Lawn, PA 19609-1324